SURGICAL-TREATMENT OF LIVER-INJURY WITH AN ABSORBABLE MESH - AN EXPERIMENTAL-STUDY

Uncontrollable bleeding remains a life-threatening problem in severe l iver injury. The application of an absorbable mesh has been reported i n a small number of patients. To evaluate an absorbable mesh wrap in s tandardized conditions, we performed an experimental study in 14 femal e pigs. A standard liver laceration imitating a blunt injury grade IV (Liver Injury Scale of the American Association for the Surgery of Tra uma) was made in all animals. Heparin was administered to mimic coagul opathy. After randomization, seven animals received a polyglycolic aci d (Vicryl) mesh wrap to control bleeding. Seven animals served as cont rols. Six of seven animals with a mesh wrap survived. Six of seven ani mals in the control group died (p = 0.02, Fisher's exact test). Intrah epatic pressures in the treated group varied from 3 to 55 mm Hg. Liver function tests in surviving animals were temporarily elevated. Necrop sy at 2 weeks demonstrated adhesions to the wrapped lobe, but no hemat oma, free bile, or abscess. Histologic examination showed a foreign-bo dy reaction to the mesh and necrotic parts in the liver. It is conclud ed that an absorbable mesh wrap can effectively control bleeding from severe liver injury and improve survival in an animal model, although it may cause some damage to liver tissue.